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Phys 15

front 1

Which expression defines vascular distensibility?

A. ΔV / (ΔP × original volume)
B. ΔP / (ΔV × original volume)
C. ΔV / (ΔP + original volume)
D. (ΔV × ΔP) / original volume

back 1

A. ΔV / (ΔP × original volume)

Distensibility = increase in volume / (increase in pressure × original volume)

front 2

Pulse pressure is best defined as:

A. Mean arterial minus venous
B. Diastolic plus systolic
C. Stroke volume minus compliance
D. Systolic minus diastolic

back 2

D. Systolic minus diastolic

front 3

Pulse pressure is most closely approximated by:

A. Compliance divided by stroke volume
B. Stroke volume times resistance
C. Stroke volume divided by compliance
D. Systolic divided by diastolic

back 3

C. Stroke volume divided by compliance

front 4

During rapid saline loading, venous volume rises much more than arterial volume for the same pressure rise mainly because:

A. Veins have higher resting tone
B. Arterioles lack elastic tissue
C. Venous valves trap the bolus
D. Arterial walls are stronger

back 4

D. Arterial walls are stronger

front 5

After a rapid transfusion, venous pressure spikes but then falls toward baseline despite continued extra blood volume. This venous behavior is called:

A. Delayed compliance
B. Pressure-wave reflection
C. Myogenic constriction
D. Critical closing pressure

back 5

A. Delayed compliance

Delayed compliance lets venous pressure normalize quickly after an initial rise.

front 6

An elderly patient has stiff large arteries and a widened pulse pressure. Which compliance change best explains this?

A. Increased
B. Decreased
C. Delayed
D. Unchanged

back 6

B. Decreased

front 7

Compared with a young elastic aorta, a stiffened aorta transmits the arterial pressure pulse:

A. More erratically
B. More rapidly
C. More slowly
D. With no change

back 7

B. More rapidly

front 8

A patient with severe calcific aortic stenosis and diminished forward flow will most likely have which pulse-pressure change?

A. Decreased
B. Increased
C. Unchanged
D. Reversed

back 8

A. Decreased

Less blood gets ejected into the aorta from LV, so the systolic pressure does not rise as much.

front 9

A premature infant has a continuous machinery murmur from a patent ductus arteriosus. Pulse pressure is most likely:

A. Decreased
B. Increased
C. Fixed
D. Absent

back 9

B. Increased

so you have blood going from aorta to pulm artery. leading to lower diastolic (in diastolic, the aorta holds pressure while heart relaxes). also the LV might have more blood to pump now, increasing systolic.

front 10

A patient with severe aortic regurgitation has bounding pulses and marked runoff during diastole. Pulse pressure is expected to be:

A. Markedly increased
B. Mildly decreased
C. Unchanged
D. Narrowed

back 10

A. Markedly increased

Aortic regurgitation can cause an extremely wide pulse pressure because diastolic pressure falls dramatically.

front 11

Central venous pressure is referenced to pressure in the:

A. Left ventricle
B. Pulmonary artery
C. Right atrium
D. Superior vena cava

back 11

C. Right atrium

front 12

Mean right atrial pressure is closest to:

A. -5 mmHg
B. 5 mmHg
C. 0 mmHg
D. 10 mmHg

back 12

C. 0 mmHg

front 13

During forceful calf-muscle contraction, venous hydrostatic pressure within compressed leg veins must:

A. Increase
B. Decrease
C. Reach zero
D. Reverse direction

back 13

A. Increase

front 14

Which organ is chiefly responsible for cleansing blood?

A. Liver
B. Spleen
C. Kidney
D. Bone marrow

back 14

B. Spleen

front 15

During rapid volume loading, which vessels are the major blood reservoir and can store about 0.5–1.0 L of extra blood?

A. Arteries
B. Capillaries
C. Veins
D. Arterioles

back 15

C. Veins

front 16

For the same increase in pressure, veins are approximately how much more distensible than arteries?

A. Twofold
B. Eightfold
C. Twelvefold
D. Twenty-fourfold

back 16

B. Eightfold

front 17

For a given rise in pressure, veins increase blood volume by about how much more than arteries?

A. Threefold
B. Sixfold
C. Eightfold
D. Twenty-fourfold

back 17

C. Eightfold

front 18

Pulmonary arteries are about how much more distensible than systemic arteries?

A. Threefold
B. Fourfold
C. Sixfold
D. Eightfold

back 18

C. Sixfold

front 19

Which best defines vascular compliance (capacitance)?

A. Resistance per pressure change
B. Flow per radius increase
C. Pressure stored per volume
D. Volume stored per pressure rise

back 19

D. Volume stored per pressure rise

front 20

Which equation correctly defines vascular compliance?

A. ΔP / ΔV
B. ΔV × ΔP
C. ΔP / original volume
D. ΔV / ΔP

back 20

D. ΔV / ΔP

front 21

Compared with an artery, venous compliance is approximately:

A. 6-fold greater
B. 8-fold greater
C. 12-fold greater
D. 24-fold greater

back 21

D. 24-fold greater

front 22

Which relationship is correct?

A. Compliance = resistance × volume
B. Compliance = distensibility × volume
C. Compliance = pressure × flow
D. Compliance = stroke volume × radius

back 22

B. Compliance = distensibility × volume

front 23

On a classic volume-pressure graph, which vessel has the curve showing far greater volume at a given pressure?

A. Artery
B. Venule
C. Capillary
D. Vein

back 23

D. Vein

front 24

A patient receives an α-adrenergic agonist that increases sympathetic tone to vessels. On the volume-pressure curve, the vessel curve shifts:

A. Rightward
B. Downward
C. Leftward
D. Upward

back 24

C — Sympathetic stimulation shifts the curve left because less volume is stored at a given pressure.

front 25

After sympathetic inhibition, the vascular volume-pressure curve shifts:

A. Leftward
B. Rightward
C. Downward
D. Upward

back 25

B — Sympathetic inhibition shifts the curve right because more volume is stored at a given pressure

front 26

Immediately after sudden vessel filling, the prompt distention is due mainly to:

A. Stress-relaxation
B. Delayed compliance
C. Smooth-muscle remodeling
D. Elastic distention

back 26

D. Elastic distention

front 27

What mechanism causes the slower phase called delayed compliance?

A. Endothelial nitric oxide release
B. Smooth-muscle stress-relaxation
C. Instant elastic recoil
D. Arteriolar vasoconstriction

back 27

B. Smooth-muscle stress-relaxation

front 28

Which best describes delayed compliance?

A. Immediate fall in resistance
B. Slow pressure change after loading
C. Fixed pressure despite volume loss
D. Reflex tachycardia after hemorrhage

back 28

B. Slow pressure change after loading

front 29

The delayed relaxation of vascular smooth muscle after stretch is called:

A. Elastic recoil
B. Stress-relaxation
C. Hysteresis
D. Pulse-wave damping

back 29

B. Stress-relaxation

front 30

If stroke volume stays constant but arterial compliance increases, pulse pressure will most likely:

A. Increase
B. Remain fixed
C. Become negative
D. Decrease

back 30

D. Decrease

front 31

During exercise, stroke volume rises while arterial compliance is unchanged. Pulse pressure will most likely:

A. Decrease
B. Remain fixed
C. Rise
D. Equal mean pressure

back 31

C. Rise

front 32

Which two variables most directly determine pulse pressure?

A. Heart rate and resistance
B. Venous tone and volume
C. Stroke volume and compliance
D. Preload and afterload

back 32

C. Stroke volume and compliance

front 33

Why does atherosclerosis typically widen pulse pressure?

A. It lowers arterial compliance
B. It raises venous capacitance
C. It slows ventricular ejection
D. It increases capillary filtration

back 33

A. It lowers arterial compliance

front 34

Which best describes transmission of the arterial pressure pulse?

A. Blood cells moving fastest
B. Retrograde venous pressure spread
C. Turbulent systolic jet formation
D. Distention wave spreading forward

back 34

D. Distention wave spreading forward

front 35

In the proximal aorta, pulse transmission usually travels at approximately:

A. 15–35 m/sec
B. 3–5 m/sec
C. 20–25 m/sec
D. 7–10 m/sec

back 35

B. 3–5 m/sec

front 36

In large arterial branches, pulse transmission speed is usually:

A. 3–5 m/sec
B. 7–10 m/sec
C. 15–35 m/sec
D. 1–2 m/sec

back 36

B. 7–10 m/sec

front 37

In small arteries, pulse transmission speed is usually:

A. 5–7 m/sec
B. 7–10 m/sec
C. 15–35 m/sec
D. 3–5 m/sec

back 37

C. 15–35 m/sec

front 38

Compared with the aorta, pressure-pulse transmission in small arteries is:

A. Slower because flow is slower
B. Equal in all vessels
C. Absent beyond arterioles
D. Faster because walls are stiffer

back 38

D. Faster because walls are stiffer

Smaller arteries are less compliant, so pulse waves travel faster.

front 39

Normal aortic pulsations largely disappear by the capillaries because of:

A. Reflection
B. Dampening
C. Backflow
D. Shunting

back 39

B. Dampening

front 40

Which equation best describes arterial dampening?

A. Resistance / compliance
B. Resistance + compliance
C. Resistance × compliance
D. Compliance / resistance

back 40

C. Resistance × compliance

front 41

A patient has unusually low arterial resistance and low arterial compliance. What happens to dampening?

A. It becomes very low
B. It becomes very high
C. It is unchanged
D. It becomes immeasurable

back 41

A. It becomes very low

front 42

Korotkoff sounds are heard when cuff pressure is:

A. Always below diastolic
B. Equal to venous pressure
C. Lower than systolic only
D. Sufficient to intermittently occlude artery

back 42

D. Sufficient to intermittently occlude artery

Korotkoff sounds occur when the artery is compressed enough to close during parts of the pressure cycle.

front 43

The first Korotkoff sound appears because:

A. Laminar flow resumes completely
B. Blood jets through compressed artery
C. Veins begin collapsing first
D. Diastolic pressure exceeds cuff pressure

back 43

B. Blood jets through compressed artery

front 44

Korotkoff sounds that persist even when the cuff is fully deflated most strongly suggest:

A. Arterial malformation or dysfunction
B. Severe venous insufficiency
C. Complete arterial occlusion
D. Marked bradycardia alone

back 44

A. Arterial malformation or dysfunction

front 45

Persistent Korotkoff sounds after full cuff deflation can be seen with:

A. Mitral stenosis or venous insufficiency
B. Pulmonary fibrosis or venous insufficiency
C. Atrioventricular fistula or aortic insufficiency
D. Tricuspid regurgitation or aortic insufficiency

back 45

C. Atrioventricular fistula or aortic insufficiency

front 46

Compared with direct catheter measurement, the auscultatory method is:

A. Exact in all patients
B. Unreliable clinically
C. Wrong by fifty percent
D. Usually within ten percent

back 46

D. Usually within ten percent

front 47

Mean arterial pressure is weighted more toward diastolic pressure because:

A. Diastole occupies more cardiac time
B. Systole generates less flow
C. Venous return exceeds ejection
D. Diastole has higher pressure

back 47

A. Diastole occupies more cardiac time

front 48

On a normal arterial pressure tracing, mean arterial pressure most closely follows:

A. Systolic pressure
B. Pulse pressure
C. Diastolic pressure
D. Central venous pressure

back 48

C. Diastolic pressure

front 49

At very high heart rates, mean arterial pressure shifts to lie:

A. Near diastolic only
B. Near venous pressure
C. Near systolic only
D. More equally between both

back 49

D. More equally between both

At high heart rates, MAP moves toward the midpoint between systolic and diastolic pressures.

front 50

Central venous pressure is also called right atrial pressure because:

A. It equals pulmonary wedge pressure
B. Systemic veins empty into right atrium
C. It reflects left atrial filling
D. It measures coronary sinus flow

back 50

B. Systemic veins empty into right atrium

front 51

Right atrial pressure is primarily determined by which two processes?

A. Systemic resistance and heart rate
B. Right-heart pumping and venous return
C. Left ventricular output and preload
D. Arterial compliance and afterload

back 51

B. Right-heart pumping and venous return

front 52

Normal right atrial pressure is closest to:

A. +5 mmHg
B. -5 mmHg
C. 0 mmHg
D. +10 mmHg

back 52

C. 0 mmHg

front 53

A patient in cardiogenic shock develops marked systemic venous congestion. Right atrial pressure may become what numbers?

A. -3 to -5 mmHg
B. 0 to +5 mmHg
C. +8 to +12 mmHg
D. +20 to +30 mmHg

back 53

D. +20 to +30 mmHg

front 54

Which situation would most likely lower right atrial pressure below zero?

A. Massive transfusion
B. Right-sided heart failure
C. Hemorrhage
D. Pulmonary edema

back 54

C. Hemorrhage

Hemorrhage lowers venous return and can reduce right atrial pressure below zero.

front 55

Exceptionally vigorous cardiac pumping with otherwise normal circulation would most likely produce a right atrial pressure of:

A. +20 to +30 mmHg
B. 0 mmHg
C. -3 to -5 mmHg
D. +4 to +6 mmHg

back 55

C. -3 to -5 mmHg

Strong heart pump = right atrium gets emptied more = RAP falls below 0.

front 56

Small peripheral veins are usually about 4–6 mmHg higher than right atrial pressure mainly because:

A. Arterioles transmit systolic pressure
B. Large veins are externally compressed
C. Capillaries actively constrict downstream
D. Lymphatic flow raises venous tone

back 56

B. Large veins are externally compressed

front 57

Early right-sided heart failure may be clinically subtle in peripheral veins because:

A. Arterioles buffer the pressure rise
B. Capillary filtration immediately falls
C. Veins dilate before pressure rises
D. Venous valves prevent backflow

back 57

C. Veins dilate before pressure rises

Peripheral veins can dilate as atrial pressure rises, so peripheral venous pressure may not initially change much.

front 58

A patient has an intra-abdominal pressure of 23 mmHg. To continue venous return, femoral venous pressure must be at least:

A. 10 mmHg
B. 23 mmHg
C. 0 mmHg
D. 35 mmHg

back 58

B. 23 mmHg

Femoral venous pressure must at least equal the surrounding abdominal pressure to keep flow going.

front 59

Gravitational pressure in the venous system is also called:

A. Oncotic pressure
B. Transmural pressure
C. Hydrostatic pressure
D. Pulse pressure

back 59

C. Hydrostatic pressure

front 60

In a motionless standing adult, venous pressure in the feet is approximately:

A. +20 mmHg
B. +35 mmHg
C. +60 mmHg
D. +90 mmHg

back 60

D. +90 mmHg

front 61

In a motionless standing adult, venous pressure in the hands is approximately:

A. +10 mmHg
B. +35 mmHg
C. +90 mmHg
D. 0 mmHg

back 61

B. +35 mmHg

front 62

While standing upright, jugular venous pressure is usually approximately:

A. +10 mmHg
B. 0 mmHg
C. -10 mmHg
D. +35 mmHg

back 62

B. 0 mmHg

front 63

In the upright position, dural sinus pressure is normally about:

A. +10 mmHg
B. 0 mmHg
C. +35 mmHg
D. -10 mmHg

back 63

D. -10 mmHg

front 64

During cranial surgery in a seated patient, negative dural sinus pressure is dangerous because it can cause:

A. Cerebral vasospasm
B. Air embolism
C. Venous thrombosis
D. CSF overproduction

back 64

B. Air embolism

front 65

In a walking person, venous pressure in the feet is usually closest to:

A. +90 mmHg
B. +60 mmHg
C. +20 mmHg
D. 0 mmHg

back 65

C. +20 mmHg

front 66

After a person stops walking and stands still, foot venous pressure usually returns toward resting standing levels in about:

A. 5 seconds
B. 30 seconds
C. 2 minutes
D. 10 minutes

back 66

B. 30 seconds

front 67

After 15–30 minutes of quiet standing, leg swelling develops mainly because:

A. Arterial flow abruptly ceases
B. Plasma filters into tissues
C. Lymphatics rupture from pressure
D. Venous valves fully close

back 67

B. Plasma filters into tissues

Prolonged standing increases capillary filtration into interstitial tissue, causing swelling.

front 68

Venous valve incompetence most directly causes:

A. Varicose veins
B. Deep arterial aneurysm
C. Lymphedema only
D. Raynaud phenomenon

back 68

A. Varicose veins

front 69

A patient with long-standing varicose veins is at risk for which complication set?

A. Cyanosis, bradycardia, syncope
B. Edema, weak muscles, ulcers
C. Jaundice, ascites, melena
D. Hemoptysis, wheeze, clubbing

back 69

B. Edema, weak muscles, ulcers

front 70

The lower neck veins begin to protrude when right atrial pressure reaches about:

A. 0 mmHg
B. +4 mmHg
C. +10 mmHg
D. +20 mmHg

back 70

C. +10 mmHg

front 71

The most direct way to determine right atrial pressure is with a:

A. Swan-Ganz balloon wedge
B. Central venous catheter
C. Radial arterial line
D. Sphygmomanometer cuff

back 71

B. Central venous catheter

front 72

The body reference level at which vascular pressure changes little with position is located near the:

A. Aortic arch
B. Mitral annulus
C. Tricuspid valve
D. Femoral vein

back 72

C. Tricuspid valve

front 73

In a supine person, the zero-pressure reference level lies at the tricuspid valve, approximately:

A. 20% chest thickness anterior
B. 40% chest thickness anterior
C. 60% chest thickness anterior
D. 80% chest thickness anterior

back 73

C. 60% chest thickness anterior

In a supine person, the zero reference level is about 60% of chest thickness anterior to the back.

front 74

Which is considered a specific blood reservoir?

A. Kidney cortex
B. Spleen
C. Brain parenchyma
D. Skeletal muscle artery

back 74

B. Spleen

front 75

Which structure can release several hundred milliliters of blood and is a specific reservoir?

A. Liver
B. Pulmonary artery
C. Coronary sinus
D. Cerebral veins

back 75

A. Liver

front 76

Which specific reservoir contributes about 300 mL of blood?

A. Great saphenous veins
B. Dural venous sinuses
C. Large abdominal veins
D. Renal venous plexus

back 76

C. Large abdominal veins

front 77

Which specific blood reservoir can contribute several hundred milliliters through cutaneous venoconstriction?

A. Skin venous plexus
B. Pulmonary capillaries
C. Carotid sinus
D. Bone marrow sinusoids

back 77

A. Skin venous plexus

front 78

Which pair can contribute blood but are not classically listed as specific blood reservoirs?

A. Brain and kidneys
B. Heart and lungs
C. Liver and spleen
D. Skin and muscle

back 78

B. Heart and lungs

front 79

The spleen can decrease in size and rapidly release approximately how much blood?

A. 25 mL
B. 100 mL
C. 300 mL
D. 700 mL

back 79

B. 100 mL

front 80

Which splenic compartment can release concentrated red blood cells and raise hematocrit by 1–2%?

A. White pulp
B. Capsule
C. Red pulp
D. Trabeculae

back 80

C. Red pulp